Clinical Presentation and Outcome of Midline Posterior Fossa Tumors: A Single Center Prospective Observational Study

Keywords

Karnofsky performance scoring - medulloblastomas - midline posterior fossa tumor

Introduction: Posterior fossa tumors constitute 50% of childhood brain. Medulloblastomas are the most common midline posterior fossa tumor in childhood. This study is designed to determine the frequency and types of midline posterior cranial fossa tumors and study the different clinical presentation of these tumors, surgical complications, and final outcome as measured by the Karnofsky performance scoring.

Methodology/Description: After permission from ethics committee, the study was performed as a prospective observational study on 60 patients admitted from March 2015 to March 2017 and operated for midline posterior fossa tumors, at the KIMS Hospital, Secunderabad. The data were entered on the predesigned form. Descriptive statistics were used for demographics. Data were analyzed using the EXCEL and SPSS softwares.

Results: The gender distribution was 38 male and 22 female patients with equal adults and children. Maximum belonged to the age group of 0 to 12 years. Of these, 52 patients presented with headache and 40 had vomiting. Blurring of vision was seen in 22 patients. Most common midline posterior fossa tumor was medulloblastoma. Postoperative hydrocephalus and seizures were seen in six patients. Out of 60 patients, 12 patients had poor outcome versus 48 patients with good outcome on the Karnofsky performance status.

Conclusion: Midline posterior fossa tumors were more common in males. Symptoms of raised ICP and cerebellar symptoms were most common presentations. Headache and histopathology of tumor: high grade or low grade shows statistically significant correlation with outcome of patients as measured with the Karnofsky performance scoring. As our study was of small duration, long-term study can give better results

• References

• 1 Yasargil MG, Abdulrauf SI. Surgery of intraventricular tumors.. Neurosurgery 2008; 62 (03) 1029-1041
• 2 Desai KI, Nadkarni TD, Muzumdar DP, Goel A. Prognostic factors for cerebellar astrocytomas in children: a study of 102 cases.. Pediatr Neurosurg 2001; 35 (06) 311-317
• 3 Panigrahi M, Krishnan SS, Varma DR. Crescent posterior fossa durotomy for occipito-marginal venous sinus preservation: a pilot study.. Acta Neurochir (Wien) 2012; 154 (11) 2115-2121